Physical Therapy for Osgood-Schlatter Disease

Exercises and Treatments Used to Improve Knee Pain in Adolescents

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A doctor examining a young girl's knee

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Osgood-Schlatter disease is a painful condition that affects the knees of growing adolescents. Treatment is focused on reducing pain and typically involves the restriction of physical activities until the pain and swelling resolve. Physical therapy is another facet of treatment that aims to strengthen and condition the affected knee.

Osgood-Schlatter disease tends to affect children during growth spurts and will usually resolve once the adolescent growth cycle is complete. With that said, Osgood-Schlatter disease can affect the quality of life of children and prevent them from forming good exercise. The early identification and treatment of Osgood-Schlatter disease can help overcome these concerns.

Symptoms

The signs and symptoms of Osgood-Schlatter disease include:

  • Pain just below the kneecap in one or both knees
  • Difficulty squatting and jumping due to knee pain
  • A noticeable bony bump in the front of the knee
  • Pain when the front of the knee is palpated (touched)
  • A visible limp

In some children, Osgood-Schlatter may cause only minor symptoms and neither interfere with physical activities nor sports. In fact, according to a 2016 review in Cureus, only 25% of people with Osgood-Schlatter complain of pain.

If your child complains of knee pain, schedule a visit with your doctor or an orthopedist to confirm or rule out Osgood-Schlatter as the cause.

Causes

Osgood-Schlatter disease is caused by irritation of the tribal tubercle, an area near the top of the shin bone where the patellar tendon attaches to the knee. This area of bone is considered a growth plate where growing bones will lengthen and enlarge during adolescence.

When a child goes through a rapid phase of growth—typically between the ages of 10 and 15 in boys and 8 and 12 in girls—the patellar tendon can pull abnormally on its insertion point on the shin bone. This can lead to pain and a noticeable bump just below the kneecap.

In addition to knee problems, children with Osgood-Schlatter may also a host of other concerns, including:

  • Tightness in the quadriceps muscle in front of the thigh
  • Hamstring and calf tightness
  • Balance or coordination issues

Diagnosis

Osgood-Schlatter disease can usually be diagnosed with a physical exam and a review of your child's medical history. The age of your child also plays a key role in the diagnosis. If some cases, an X-ray may be ordered if the symptoms are unusual or severe, mainly to rule out other possible causes of pain, swelling, and joint deformity.

Treatment

Osgood-Schlatter disease is treated conservatively. This typically involves limiting exercises, sports, or physical activities that cause pain—often for weeks or month—until the pain and swelling subside. This should then be followed by a strength conditioning program overseen by a licensed physical therapist.

If your child does not have a limp or significant pain, participation in sports may be safe to continue as long as your doctor approves.

If your child is diagnosed with Osgood-Schlatter disease, a physical therapy program would typically begin with a baseline assessment of your child's:

Based on the evaluation, the physical therapist can design a targeted exercise program to effectively treat Osgood-Schlatter disease. This may involve:

  • Stretching exercises: Many children with Osgood-Schlatter disease have tightness in one or more muscle groups in the lower extremities. To remedy this, your therapist may incorporate hamstring stretches, quad stretches, and calf stretches into the program.
  • Strengthening exercises: The restriction of movement during recovery can cause muscles to shorten and shrink (atrophy). To rectify this, the therapist would include exercises aimed at strengthening the quadriceps, hamstrings, and hip muscles. Lunges and squats are great ways to achieve this.
  • Balance and coordination exercises: Some children with Osgood-Schlatter experience impaired balance and coordination. To overcome this, your therapist would teach balance exercises like the T-Stance—in which you stand on one leg and lean forward with your arms outstretched—to improve balance and strengthen in the affected knee, hip, and ankle.
  • Pain control: Heat and ice application can be used, respectively, to loosen tight joints and reduce pain and inflammation. Kinesiology tape may also help by supporting the knee.

    Ultimately, the best treatment for Osgood-Schlatter disease is an active exercise program that includes stretching, strengthening, and mobility. Passive treatments like heat, ice, or taping may feel good, but they do little to improve the underlying condition.

    Most cases of Osgood-Schlatter disease are self-limiting and resolve on their own without treatment. Those that involve severe pain or limping may take 12 to 24 months to fully resolve.

    To speed recovery, it almost always helps to have an informed exercise plan designed to strengthen and stabilize the knee. By working with a physical therapist, you're bound to recover quicker than sitting on the sidelines at home.

    A Word From Verywell

    If your child is diagnosed with Osgood-Schlatter disease, there are several things you should do to prevent the worsening of symptoms. First of all, don't panic. As distressing as the condition may be, it rarely causes long-term harm or damage.

    Secondly, seek appropriate care. While you may assume that Osgood-Schlatter is the cause of your child's knee pain, there are many other conditions with similar symptoms. By obtaining the correct diagnosis, you can treat the condition more effectively.

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    Article Sources

    1. Vaishya R, Azizi AT, Agarwal AK, Vijay V. Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review. Cureus. 2016 Sep;8(9):e780. doi:10.7759/cureus.780.

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